Originally created 10/16/96

Technicians replacing nurses at hospitals



The person changing your wound dressing at the local hospital might be wearing a nursing outfit, but there's a good chance he or she is not a licensed nurse, state nursing leaders say.

Cost-cutting measures in this era of managed care have prompted many hospitals to replace nurses with less-experienced and lower-paid technicians, jeopardizing patient care, say some nurses attending the 1996 Georgia Nurses Association's annual convention.

"I did a survey of the hospitals in the Augusta area, and I found that the bulk of unlicensed care-givers have about two weeks of formal education," said Sandy Turner, president of the GNA district that includes Augusta.

While tasks such as wound dressing, bathing, and patient education are increasingly falling to on-the-job-trained technicians, the remaining licensed nurses are finding themselves burdened with administrative tasks that take them away from patient interaction, a problem that is being addressed at this week's three-day convention, which ends Friday at the Radisson Riverfront Hotel Augusta.

"Nurses are going to have to adapt to the changing job market. Managed care is a fact that we are going to have to live with," said Julie Williamson, GNA assistant executive director.

Only a few years ago, there was a nursing shortage, with nurses fresh from school starting out with salaries as high as $25 an hour. But now, the job market for inexperienced licensed nurses has shrunk, and graduates are finding themselves taking jobs alongside minimum-wage technicians.

"One of the biggest expenses for hospitals is nursing salaries, but it's a mistake for hospitals to think they can save money while safety of care is compromised. Studies have shown the rate of infection rises when nurses are replaced," said Betty Daniels, a retired nurse from Stockbridge.

The hospital job shrinkage means Georgia's 75,000 licensed nurses are going to have to get advanced degrees or create their own jobs, nurses say. With managed care programs emphasizing fewer hospital days for patients, that means more nurses are going to be working outside the hospital, in clinics or at patients' homes.

"Working outside the hospital setting, there are less benefits, and salaries are lower for nurses," said Ms. Turner. "It's going to be hard to attract qualified nurses for quality patient care under those conditions."

But officials with Augusta's largest hospital say the job market remains solid for trained nurses.

"Nationwide, the number of nurses working at hospitals has increased by 2.5 percent," said Marilyn Bowcutt, vice president for patient care at University Hospital.

Despite ongoing staff cutbacks, the hospital has retained its in-patient- to-nurse ratio, and has increased the number of technicians to help the nurses treat their patients, Ms. Bowcutt said.

"We are actually spending more nursing hours on today's patient, because they are sicker," said Ms. Bowcutt, who said other, less-acutely ill patients are increasingly being treated on a more cost-efficient outpatient basis.

"Nurses are going to play an increasingly important role in how we provide care to our patients," Ms. Bowcutt said. "We couldn't afford to do otherwise."